Provider Demographics
NPI:1851402416
Name:DAVIS, CYNTHIA J (MSW, LGSW)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:J
Last Name:DAVIS
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 E SARNIA ST STE 2100
Mailing Address - Street 2:
Mailing Address - City:WINONA
Mailing Address - State:MN
Mailing Address - Zip Code:55987-6414
Mailing Address - Country:US
Mailing Address - Phone:507-454-4341
Mailing Address - Fax:507-453-6267
Practice Address - Street 1:215 PERRY HILL RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-3725
Practice Address - Country:US
Practice Address - Phone:334-272-4670
Practice Address - Fax:334-725-2986
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN316271041C0700X
AL1090G104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical